Category: Cardiovascular

Daily strawberry consumption was linked to improved cognitive function, lower blood pressure and higher antioxidant capacity in a randomized clinical trial presented today at Nutrition 2023, the annual meeting of the American Society of Nutrition (ASN). The study was conducted at San Diego State University and builds on previous research demonstrating the cardiovascular, metabolic and cognitive health benefits of strawberries. The double-blind, placebo-controlled study was conducted in 35 healthy men and women, aged 66 to 78. The participants consumed 26 grams of freeze-dried strawberry powder, equivalent to two servings of strawberries daily, or a control powder for eight weeks each. Following strawberry consumption, cognitive processing speed increased by 5.2%, systolic blood pressure decreased by 3.6% and total antioxidant capacity significantly increased by 10.2%. Waist circumference decreased by 1.1% during both the control and intervention arms of the trial. While consuming the control powder, participants experienced increased serum triglycerides. This study demonstrates that consuming strawberries may promote cognitive function and improve cardiovascular risk factors like hypertension. We’re encouraged that a simple dietary change, like adding strawberries to the daily diet, may improve these outcomes in older adults.” Shirin Hooshmand, professor in the School of Exercise and Nutrition Sciences at San Diego State and principal investigator on the study Strawberries are a source of many bioactive compounds. In addition to providing 100% of our daily vitamin C needs, strawberries contain heart-healthy nutrients like folate, potassium, fiber, phytosterols and polyphenols. Previous clinical trials have connected strawberry consumption to improvements in several markers for cardiovascular disease, including reduced total and LDL cholesterol (TC) and lower blood pressure. The link between strawberry consumption and brain health has also been well explored in both clinical and population-based studies. Strawberries and pelargonidin, a biochemical primarily found in strawberries, were associated with a reduced risk of Alzheimer’s dementia in studies conducted at Rush University. Long-term observational studies, including the Health Professionals Study and the Nurses’ Health Study, found that strawberry consumers had lower rates of cognitive decline. American Society of Nutrition

July 24, 2023 — Allegheny General Hospital (AGH), the flagship academic medical center of Allegheny Health Network (AHN), announced today it has once again received the Mitral Valve Repair Reference Center Award from the American Heart Association (AHA) and the Mitral Foundation for a demonstrated record of superior clinical outcomes resulting from evidence-based, guideline-directed degenerative mitral valve repair. This is the third consecutive year AGH and its AHN Cardiovascular Institute team have been recognized as a Mitral Valve Repair Reference Center since the recognition was established in 2019, placing AHN’s program among the most elite nationwide. To date, only 21 facilities have earned this award across the country and AGH remains the only hospital to receive this recognition in Pennsylvania. “This award recognizes the commitment of our clinicians and caregivers who provide the highest levels of care to our patients, year after year,” said Walter E. McGregor, MD, lead surgeon of the AHN mitral valve program and director of AHN cardiac surgery at AHN Cardiovascular Institute. “On behalf of the entire Network, I want to extend my sincere gratitude to their tireless work that upholds the AHN Cardiovascular Institute’s longstanding legacy of clinical excellence.” The mitral valve is in the left side of the heart and works to keep blood flowing properly in one direction from the left atrium to the left ventricle. When the valve doesn’t work correctly, allowing blood to flow backward, the heart can’t pump enough oxygenated blood for the body. Symptoms of mitral valve regurgitation often include fatigue and shortness of breath. Mitral valve repair is considered the gold-standard therapy for degenerative mitral valves and is generally preferred over mitral valve replacement since valve repair is associated with improved survival and fewer long-term complications. Valve replacement with a bioprosthetic or mechanical valve typically has higher five-to-ten-year complication rates compared to repair. “We are pleased to recognize Allegheny General Hospital for their commitment to patients who need mitral valve repair,” said Robert O. Bonow, MD, professor of cardiology at Northwestern University and past president of the American Heart Association. “Choosing the right hospital for heart surgery is one of the most important health care decisions that patients and their referring physicians must make to ensure best outcomes. The Mitral Valve Repair Reference Center award identifies hospitals with excellent processes and outcomes and gives patients and cardiologists the information necessary to make these important decisions when mitral valve surgery is required.” The Mitral Valve Repair Reference Center Award was developed to identify, recognize and promote the nation’s recognized medical centers for mitral valve repair surgery. AGH earned the award for demonstrating adherence to evidence-based treatment guidelines as well as an ongoing commitment to reporting and measuring quality and outcome metrics specific to mitral valve repairs. “This such a meaningful designation as it is contingent on superb outcomes — 95% repair rate and less than 1% mortality — in a high volume of patients and verified by the AHA,” said Stephen Bailey, MD, cardiothoracic surgeon and Chair of AHN Cardiovascular Institute. “We’re incredibly proud of today’s recognition as it further establishes our program as a nationally recognized leader in managing and treating complex cardiovascular disease.” For more information: www.ahn.org

SUITA, Japan: The World Health Organization reports that cardiovascular disease is the leading cause of death globally, and there are proven links between cardiovascular disease and periodontal disease. A recent study by a team at Osaka University Hospital has investigated whether the timing of toothbrushing affects the risk of developing cardiovascular disease. It turns out that the importance of brushing at night expands beyond the benefits of tooth retention. For the study, researchers enrolled 1,583 patients aged 20 years and older who were hospitalised for surgery, other medical treatment or examination. They found that participants who brushed their teeth both in the morning and at night and those who brushed only at night had significantly higher survival estimates for cardiovascular events compared with those who did not brush their teeth at all. Additionally, smokers who did not brush had a worse prognosis for cardiovascular onset events than did smokers who brushed only in the morning, only at night or both, and non-smokers who did not brush or who brushed only in the morning also showed worse prognosis on hospitalisation. The researchers concluded that brushing teeth at night is important for reducing the risk of cardiovascular disease. They suggested that increased intra-oral bacterial load during sleep owing to reduced salivary flow may cause periodontal disease or dental caries, impairing mastication and spreading oral bacteria to the intestines and blood, thereby negatively affecting general health and leading to cardiovascular events. However, the authors recommended undertaking a multicentre study with a longer observation period to generalise the study results and explore the mechanism behind the observed relationship between toothbrushing timing and cardiovascular disease risk. While the study’s findings are limited to hospitalised patients and cannot be generalised to healthy populations, they highlight the significance of proper toothbrushing habits for maintaining good oral and systemic health. The study emphasises the importance of increasing awareness about appropriate toothbrushing timing in the general population to potentially prevent cardiovascular disease. The study, titled “Not brushing teeth at night may increase the risk of cardiovascular disease”, was published on 28 June 2023 in Scientific Reports. Related articles

NEW YORK – The US Food and Drug Administration has granted 510(k) clearance to Numares Health’s Axinon LDL-p test for measuring lipoproteins and identifying patients at risk for cardiovascular disease, the medtech firm said Tuesday. Numares, which has offices in Boston and Regensburg, Germany, developed the Axinon LDL-p test system as a diagnostic that physicians can use to measure the concentration of low-density lipoprotein particles (LDL-p) in a patient’s blood, high levels of which have been associated with risk of developing cardiovascular disease. The regulatory clearance also comprises the firm’s technology platform, the AXINON System, which incorporates diagnostic algorithms that quantify biomarkers and nuclear magnetic resonance spectroscopy. FDA clearance of the platform as part of the LDL-p test system will provide a pathway for Numares to garner clearance of other tests it is developing for metabolic conditions, the firm said. Numares is expecting to receive FDA clearance for another assay, the Axinon GFR (NMR) test for gauging kidney function, later this year.

Tian Wang, APD, RD Credit: ResearchGate Consumption of a vegetarian diet may have modest, but significant improvements in cardiometabolic outcomes beyond standard therapy in individuals with or at high risk of cardiovascular diseases (CVDs), according to new research.1 The systematic review and meta-analysis of 20 randomized controlled trials (RCTs) suggested a vegetarian diet in these high-risk patients was associated with significant improvements in low-denisty lipoprotein cholesterol (LDL-C), hemoglobin A1c (HbA1c), and body weight. “Vegetarian diets were most effective in glycemic control among people with type 2 diabetes (T2D), and led to favorable changes in weight in people at high risk of CVD and in those with T2D, suggesting that vegetarian diets might have a synergistic (or at least nonantagonistic) use in potentiating the effects of optimal drug therapy in the prevention and treatment of a range of cardiometabolic diseases,” wrote the investigative team, led by Tian Wang, APD, RD, from the Charles Perkins Centre, faculty of medicine and health, at the University of Sydney. Poor diet has been linked to an elevated risk of CVD morbidity and mortality. Dietary guidelines released by the American Heart Association in 2021 indicated the importance of dietary patterns rich in minimally processed plant foods, fish, and seafood, and low-fat dairy products. On the other hand, diabetes organizations have recommended the consumption of a well-balanced vegetarian diet in line with evidence suggesting their effect at preventing T2D and its metabolic complications. There are accumulating data from meta-analyses of RCTs showing a role of vegetarian diet in the primary prevention of CVDs in the general population. However, little is known regarding their effectiveness on those with or at high of CVDs. The objective of the current meta-analysis was to assess the association of vegetarian diets with major cardiometabolic risk factors, with eligible RCTs measuring LDL-C, HbA1c, or systolic blood pressure (SBP). A systematic search was performed in Embase, MEDLINE, CINAHL, and CENTRAL from inception until July 2021. Of 7871 records screened, 29 (0.4%; 20 studies) met inclusion criteria. In the investigative team, 2 reviewers independently extracted data including demographics, study design, sample size, and diet description, and performed risk of bias assessment. The analysis used a random-effects model to assess mean changes in LDL-C, HbA1c, SBP, and body weight between preintervention and postintervention for the primary outcomes. Secondary outcomes included change in body weight and energy intake. The 20 studies were conducted across the US, Asia, Europe, or New Zealand, involving 1878 participants, and the mean duration of intervention was 25.4 weeks. Of the included trials, 4 targeted people with CVDs, 7 focused on diabetes, and 9 included individiauls with ≥2 CVD risk factors. Upon analysis of 19 studies, the consumption of a vegetarian diet was found to be associated with a significantly decreased LDL-C by 6.6 mg/dL (95% CI, -10.1 to -3.1 mg/dL) over a mean of 6 months beyond that achieved with standard therapy. The most consistent reduction was observed among people at high risk of CVDs (-9.1 mg/dL; 95% CI, -12.7 to -5.5 mg/dL). An analysis of 10 studies investigating HbA1c found that consuming vegetarian diets was associated with decreased HbA1c by 0.24% (95% CI, -0.40 to -0.07) in a mean 6 months of intervention. Results from 16 trials included in a meta-analysis of body weight showed weight decreased by 3.4 kg in a mean 6 months of intervention in individuals randomized to vegetarian diets (95% CI, -4.9 to -2.0 kg). However, a meta-analysis of 14 studies revealed the pooled effect size of vegetarian diets on SBP was not statistically significant (-0.1 mmHg; 95% CI, -2.8 to 2.6 mmHg). In the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessment, investigators found the level of evidence was rated moderate for LDL-C and HbA1c reduction and low for SBP and weight reduction. “Well-designed nutrition clinical trials with comprehensive dietary information are warranted to investigate the full effect of high-quality vegetarian diets in combination with optimal pharmacological therapy in people with CVDs,” the team wrote. References Wang T, Kroeger CM, Cassidy S, et al. Vegetarian Dietary Patterns and Cardiometabolic Risk in People With or at High Risk of Cardiovascular Disease: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023;6(7):e2325658. doi:10.1001/jamanetworkopen.2023.25658 Lichtenstein AH, Appel LJ, Vadiveloo M, etal. 2021 dietary guidance to improve cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2021;144(23):e472-e487. doi:10.1161/CIR. 0000000000001031

Although statins are a class I recommendation for prevention of atherosclerotic cardiovascular disease and its complications, their use is suboptimal. Differential underuse may mediate disparities in cardiovascular health for systematically marginalized persons.To estimate disparities in statin use by race-ethnicity-gender and to determine whether these potential disparities are explained by medical appropriateness of therapy and structural factors.Cross-sectional analysis.National Health and Nutrition Examination Survey from 2015 to 2020.Persons eligible for statin therapy based on 2013 and 2018 American College of Cardiology/American Heart Association blood cholesterol guidelines.The independent variable was race-ethnicity-gender. The outcome of interest was use of a statin. Using the Institute of Medicine framework for examining unequal treatment, we calculated adjusted prevalence ratios (aPRs) to estimate disparities in statin use adjusted for age, disease severity, access to health care, and socioeconomic status relative to non-Hispanic White men.For primary prevention, we identified a lower prevalence of statin use that was not explained by measurable differences in disease severity or structural factors among non-Hispanic Black men (aPR, 0.73 [95% CI, 0.59 to 0.88]) and non-Mexican Hispanic women (aPR, 0.74 [CI, 0.53 to 0.95]). For secondary prevention, we identified a lower prevalence of statin use that was not explained by measurable differences in disease severity or structural factors for non-Hispanic Black men (aPR, 0.81 [CI, 0.64 to 0.97]), other/multiracial men (aPR, 0.58 [CI, 0.20 to 0.97]), Mexican American women (aPR, 0.36 [CI, 0.10 to 0.61]), non-Mexican Hispanic women (aPR, 0.57 [CI, 0.33 to 0.82), non-Hispanic White women (aPR, 0.69 [CI, 0.56 to 0.83]), and non-Hispanic Black women (aPR, 0.75 [CI, 0.57 to 0.92]).Cross-sectional data; lack of geographic, language, or statin-dose data.Statin use disparities for several race-ethnicity-gender groups are not explained by measurable differences in medical appropriateness of therapy, access to health care, and socioeconomic status. These residual disparities may be partially mediated by unobserved processes that contribute to health inequity, including bias, stereotyping, and mistrust.National Institutes of Health.

BioCardia has paused its pivotal phase III CardiAMP Cell Therapy Heart Failure trial to allow time for one-year follow-up outcomes to be analyzed. The interim data are promising, but the news caused BioCardia shares to plummet 46% to a new 52-week low. @microscience stock.adobe.com CardiAMP Cell Therapy, believed to be the first cardiac cell therapy to receive FDA Breakthrough Device status, uses the patient’s own bone marrow cells to potentially stimulate the natural healing response. When the cells are injected into the heart muscle, it is believed that they release proteins that signal other cells to repair themselves. The company says it’s a different mechanism of action from other therapies that have sought to transform stem cells into new heart cells, a method that has presented patient risks, such as rhythm abnormalities and cell rejection. This trial is the first multicenter clinical trial using stem cell therapy to prospectively screen cells for therapeutic potency. “Past trials of cell therapy delivered intramyocardially showed benefit in improving heart function,” BioCardia CEO Peter Altman, Ph.D., “but they did not reach statistical significance. We learned from these earlier approaches and added three elements that we believe improve our probability of success: a pre-procedural diagnostic for patient selection, a high target dosage of cells, and a proprietary delivery system that has been shown to be safer than other intramyocardial delivery systems and exponentially more successful in cell retention.” This approach, he says, allows the patient to be discharged from the hospital the morning after the procedure. Related: Inpefa, a New Heart Failure Drug, Surpasses Cost-Effectiveness Threshold The pause — unrelated to any emergent safety events — was recommended by the independent data safety monitoring board. The board’s interim review was based on available data for 132 procedures involving 111 patients from both treatment and control groups. The prespecified statistical analysis plan provided that the monitoring board would use a composite endpoint that considered survival, major adverse cardiac and cerebrovascular events, and six-minute walk distance at 12 months. It did not include other endpoints that are part of the trial, such as quality of life and heart function assessment. The blinded data show that the survival rate at follow-up is greater than that observed in recent similar large pivotal trials in patients with heart failure with reduced ejection fraction. The blinded data also show improved health outcomes in aggregate for patients followed through all key visit dates over 12 months. The data don’t disclose differences in outcomes between the treated and control groups. According to a Biocardai press release, the board recommended that the blind not be broken, to protect the integrity of the outcomes yet to be collected and “to ensure that the study may be restarted without compromise after completion of the one-year data analysis.” It also recommended that the company continue to treat patients already enrolled. “We are pleased that there appear to be no treatment emergent safety issues and that the health outcomes measured in the trial show improvement for patients a compromise group,” said Altman. “We will utilize this pause to accelerate our CardiAMP Chronic Myocardial Ischemia Trial and our CardiALLO Heart Failure trial with our world-class clinical partners.”

TUESDAY, July 25, 2023 (HealthDay News) — For patients with HIV infection, those receiving pitavastatin have reduced risk of major adverse cardiovascular events over a median follow-up of 5.1 years, according to a study published online July 23 in the New England Journal of Medicine to coincide with the IAS Conference on HIV Science, held from July 23 to 26 in Brisbane, Australia. Steven K. Grinspoon, M.D., from Massachusetts General Hospital in Boston, and colleagues randomly assigned 7,769 participants with HIV infection and a low-to-moderate risk of cardiovascular disease who were receiving antiretroviral therapy to receive daily pitavastatin calcium or placebo. After a median of 5.1 years, the trial was stopped early for efficacy. The researchers found that the incidence of a major cardiovascular event was 4.81 and 7.32 per 1,000 person-years in the pitavastatin and placebo groups, respectively (hazard ratio, 0.65). Muscle-related symptoms occurred in 2.3 and 1.4 percent of the pitavastatin and placebo groups, respectively, and diabetes mellitus occurred in 5.3 and 4.0 percent, respectively. “This observed reduction was larger than that predicted by the Cholesterol Treatment Trialists’ Collaboration on the basis of the achieved reduction in low-density lipoprotein cholesterol levels,” the authors write. “This finding suggests effects on cardiovascular risk beyond those associated with the lowering of LDL cholesterol alone.” #placement_588494_0_i{width:100%;margin:0 auto;} Several authors disclosed ties to pharmaceutical companies, including Kowa Pharmaceuticals America, Gilead Sciences, and ViiV Healthcare, which supported the study. Abstract/Full Text (subscription or payment may be required) Editorial (subscription or payment may be required) More Information

A recent analysis identified several trends among adults with anaphylaxis, including the following: increasing age is linked to more severe presentations, medications are more frequent trigger in older adults, and food-related anaphylaxis is both a risk factor for recurrent cases and the most common trigger.1 These findings and others resulted from a study which set out to assess the risk factors in adult patients with severe and recurrent anaphylaxis presentations. The study also sought to examine patient management strategies related to the cascade of care recommendations. The research was authored by Jacqueline Loprete, MBBS, from the Immunology and HIV Unit of St. Vincent’s Hospital in Sydney, Australia. “By identifying risk factors, including comorbidities and potential gaps in education and ongoing management after initial anaphylaxis, it may be possible to reduce anaphylaxis incidence or severity,” Loprete and colleagues wrote. The investigators conducted the study at St. Vincent’s Hospital in Sydney, Australia, a tertiary-care facility with 402 beds that is known to treat patients aged 16 years and older. The hospital’s ED receives over 49,000 anaphylactic presentations annually. The research team’s work involved auditing the records of individuals who visited the hospital’s ED with anaphylactic presentations in the time frame between January of 2009, and December of 2018. Data from electronic and paper records were reviewed by the team, covering various aspects including medical history, demographics, presenting event information, co-factors involved, treatment given, and discharge disposition. Severe anaphylaxis, as per the Brown criteria, was defined by specific symptoms.2 The investigators also assessed whether the recommended cascade of care was carried out for each individual, including steps like monitoring, adrenaline administration, providing an adrenaline autoinjector at discharge, and advising follow-up with a specialist in allergies. The data collected by the research team were entered into an electronic data collection form and analyzed using Stata, and their analysis involved examining associations through the use of odds ratios (ORs) and t-tests to compare distinctions between various groups. Overall, the investigators’ research involved 616 patients (median age: 31 years, 56.3% female) recorded 689 occurrences in total, with 8.3% of patients experiencing anaphylaxis on at least 2 occasions. In 68.7% of episodes, the triggering agents were identified by the research team. The primary triggers were found to be food-related (73.4% of cases with known triggers), with peanuts and seafood being the most common culprits. Among these food-related episodes, 76.4% were associated with food consumed outside one’s home or consuming food prepared by others. Additionally, the investigators reported that drugs and medications were shown to be the second most prevalent triggers (22.4% of episodes), and that non-steroidal anti-inflammatories being the major contributor. Individuals over the age of 65 were found to have identifiable triggers for anaphylaxis more often than younger individuals, with drugs/medications identified by the investigators as the predominant trigger in this age group (75% vs. 20.1% in those under 65). Being over 65 and having a history of asthma were noted as independent risk factors for severe anaphylaxis. The investigators also noted that a history of food allergy and food as the trigger were found to have been linked with recurrent anaphylaxis presentations in these patients. Only 19% of those included followed the recommended cascade of care, with deficiencies observed by the team in post-adrenaline monitoring and referrals to allergy specialists. The study’s investigators also reported an increase in anaphylaxis presentations over time but no major differences in triggers or severity. “More work is required to further establish possibly modifiable risk factors for anaphylaxis in adults with allergies and to work with healthcare professionals to ensure that education and appropriate resources are delivered and expected standards followed, to address these gaps in care,” they wrote. Loprete J, Montemayor J, Bramah V, et al. Predictors of severe and recurrent adult anaphylaxis, and gaps in the cascade of care: a retrospective, single-centre study 2009-2018 [published online ahead of print, 2023 Jul 18]. Intern Med J. 2023;10.1111/imj.16177. doi:10.1111/imj.16177. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42: 377–81.

JAMA Network About The Study: The results of this study suggest that consuming a vegetarian diet may modestly but significantly improve cardiometabolic outcomes beyond standard pharmacological therapy in individuals at high risk of cardiovascular diseases (CVDs), highlighting the potential protective and synergistic effects of vegetarian diets for the primary prevention of CVD. Authors: Tian Wang, A.P.D., R.D., of the University of Sydney in Sydney, New South Wales, Australia, is the corresponding author. To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ (doi: 10.1001/jamanetworkopen.2023.25658) /Public Release. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).View in full here.